Individual
CAROLYN KAY CLEVENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
12 EXECUTIVE PARK DR NE, SUITE 504, ATLANTA, GA 30329-2206
(404) 778-3444
Mailing address
1152 ALBEMARLE WAY, LAWRENCEVILLE, GA 30044-8142
(770) 339-5806
(770) 339-5806
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN153941
GA
Other
Enumeration date
05/16/2007
Last updated
06/16/2015
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